Sex Reassignment alludes to procedures that help individuals alter their sexual characteristics so that these people are aligned with their gender attribute. This type of surgery is a critical element of gender transition for many persons who experience gender dysphoria, a condition where the individual’s gender identification does not match their assigned sex at birth.

If your birth sex (male or female) does not align with your gender identity (gender incongruence), you may benefit from gender affirmation surgery. It may be beneficial if you are experiencing psychological suffering as a result of gender incongruity (gender dysphoria).

Nearly 25 % to 35 % of non-binary and trans people in the United States go for gender affirmation surgery. As per a 2023 report, top surgeries, followed by bottom surgeries and facial reconstruction surgeries are the most common surgeries that people opt for.

Types

Reconstruction surgery of the face to intensify masculine or feminine face traits.
Vocal surgery to alter your voice pitch.
Chest or “top” surgery to cut back breast tissue to produce a more masculine look or add breast size and form to produce a feminine look.
Genital or “bottom” surgery to alter and reconstruct the genitals.

Benefits

Visual aspects, that include changes in the way your face, chest or genitals look.
Expression of sexuality, that includes how you look, sound and do routine things (like peeing standing up or sitting down).
Sexual behavior, that includes sexual activities in a manner that fits with your gender.

Risks

As with any surgery, a nominal risk of complications, can include:

Bleeding
Infection
Side effects of anesthesia.

Sex Reassignment Surgery Procedure

1) For those transformation from male to female (MTF)

Vaginoplasty is the better preferred option procedure that involves the initiation of a neovagina using penile and scrotal tissue or other sources. Orchiectomy, that involves the separation of testicles, is normally carried out to cut down testosterone levels.

2) Female-to-male (FTM) procedures commonly include:

Top surgery, which takes out breast tissue to develop a more masculine chest, and
Phalloplasty, where a neophallus is constructed using tissue from the remaining part of the body like the forearm or thigh. Post-surgery, patients may undergo procedures like tracheal shave, rhinoplasty, or jaw contouring for additional facial feminization.

3) Preparation for the Surgery

The healthcare expert will discuss with you about gender-affirming surgery as per the World Professional Association for Transgender Health (WPATH) standards of care. This social group encourages scientifically validated methods for transgender and gender-diverse people.

Different criteria include:

Providing informed acceptance.
- You’ll need to understand the surgery that takes place, its side-effects and how it will shape your life ahead. These effects can in ways can widen your desire to have natural born children. Many surgeries can lead to short-lived or lasting infertility. You will have to learn about fertility preservation options, like freezing your eggs or sperm.

An account of gender incongruence
- Health data that includes a history of gender incongruence (usually a year or more) may be needed.

A mental health assessment
- A letter of power from a qualified mental health provider (therapist, psychiatrist or social worker), will make sure the safest and healthiest options that relate to your gender identity.
- If you suffer from gender dysphoria, they will help to diagnose and treat related conditions, like anxiety and depression.

Hormone therapy
- In rare cases, hormone therapy may be required before surgery. Hormones can cause changes in your body that depend on the surgery and the effective outcomes to make the surgery more productive.

The healthcare provider may carry out some tests, that include:

Blood tests
A physical exam
Imaging tests

4) During the Gender Affirmation Surgery

Anesthesia is administered so you won’t experience any pain during the surgery. In accordance with the procedure, your surgeon will:

Take away or reorganize tissue or organs.
From the existing tissue new structures will be created.
Put tissue grafts or implants in.

In addition, a Foley catheter may be installed to assist with urination or drains to remove fluid from wounds.

How Long Does the Procedure Last?

Depending on the surgery the procedure may take a whole day or it may be done in sessions. For instance, top surgery is completed in a day whereas phalloplasty is spread over multiple sessions. The below mentioned points should be discussed with the healthcare provider that include:

If the surgery is complete in a day or you need to come in multiple sessions.
The duration of each surgery.
How soon you will be able to see the final outcome.

What Things You Should Not Do After The Surgery

There are some things which should be taken care and avoid these things:

Follow the healthcare provider’s direction on how to wash your wounds and monitor for infection.
Avoid smoking.
Avoid physical activity and limit exercise.
Take drugs in time and do not take other medications until the doctor has prescribed them for you.
Discuss nutritious dietary selections that will aid in recovery with your healthcare physician.